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ORIGINAL RESEARCH article
Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 13 - 2025 | doi: 10.3389/fbioe.2025.1551993
Adjusting Blood Redistribution to Suppress Flow Disturbance of Hemodialysis Arteriovenous Fistula: A Computational Fluid Dynamics Analysis
Provisionally accepted
Yong-Jiang Li 
Hui-Min Hou Zheng Liu 
Chun-Dong Xue Jing-Tong Na Qing-Mei Meng Zhe-Yuan Li Hai-Yang Sun Yu-Lin Wu Shu-Xin Liu *
Kairong Qin *- Dalian University of Technology, Dalian, China
The dramatical hemodynamic disturbances induced by arteriovenous fistula (AVF) creation are universally acknowledged as the triggering factors AVF dysfunction. The postoperative blood redistribution is greatly relevant with the flow disturbances of AVF such as disturbed flow, low wall shear stress (WSS), and oscillating WSS. However, the relationship between blood redistribution and the hemodynamic disturbances of AVF remains unexamined. The role of clinically observed retrograde blood flow at distal radial artery is rarely understood. In this study, an idealized AVF model was developed with clinical data collected from the patient with End-Stage Renal Disease. By considering the postoperative blood redistribution, the influence of blood flow rate ratio on the hemodynamic disturbances are numerically studied. The results demonstrate that the creation of AVF can result in the flow disturbance, including vortex, reciprocating flow, low and reciprocating WSS, whose occurrence regions are consistent with clinical observations. The flow rate ratio and flow direction of distal radial artery play important roles in regulating the low WSS area within the AVF anastomosis, especially for the flow rate of the proximal radial artery. Moreover, the clinically observed retrograde blood flow at distal radial artery contributes to the reduction of low WSS area, revealing a compensation mechanism. This study can provide valuable insights for understanding the effect of blood redistribution on flow disturbance in AVF and the compensatory role of retrograde distal radial artery flow, which help optimize blood redistribution for a well-functioning AVF.
Keywords: Arteriovenous Fistula, Blood redistribution, computational fluid dynamics, Flow Disturbance, hemodialysis
Received: 27 Dec 2024; Accepted: 24 Feb 2025.
Copyright: © 2025 Li, Hou, Liu, Xue, Na, Meng, Li, Sun, Wu, Liu and Qin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Shu-Xin Liu, Dalian University of Technology, Dalian, China
Kairong Qin, Dalian University of Technology, Dalian, China
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